New Visit
patient
Patient Name:
Phone number:
PD of patient:
visits:
Date of visit:
12/26/2024 1:14:00 PM
Cost:
70
Service:
Frame + Lenses
prescribed by doctor:
luna
Notes:
Metalic Frame+ AR
SPH
CYL
AX
ADD
OD
-0.5
110
OS
-0.5
65
Date of visit:
6/23/2026 3:28:00 PM
Cost:
85
Service:
Frame+Lenses
prescribed by doctor:
Old RX
Notes:
Metal Frame + AR TRANS W9
SPH
CYL
AX
ADD
OD
-0.5
110
OS
-0.75
55
New visit Information
Date of visit:
Cost in this visit:
type of service:
prescribed by doctor
Note:
SPH
CYL
AX
ADD
OD
OS
Back to List